Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive decline in renal function. History significant for exposure to Aristolochic acid via [herbal supplements/contaminated grain]. Symptoms include polyuria, nocturia, and anemia disproportionate to the degree of renal impairment. No history of hypertension or diabetes.
Clinical Examination Findings
General appearance: Pale, chronically ill. Vitals: Normotensive or mildly hypertensive. Skin: No rashes or signs of systemic vasculitis. Edema: Absent or minimal. Neurological: No signs of uremic encephalopathy.
Treatment Protocol
Immediate cessation of all Aristolochic acid-containing substances. Supportive care for CKD. Strict monitoring for upper tract urothelial carcinoma (UTUC) via serial urine cytology and periodic CT urography/ureteroscopy. ACE inhibitors/ARBs for proteinuria management.